Provider Demographics
NPI:1568600286
Name:CHICAGO CARDIOLOGY INSTITUTE S.C.
Entity Type:Organization
Organization Name:CHICAGO CARDIOLOGY INSTITUTE S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PARAG
Authorized Official - Middle Name:
Authorized Official - Last Name:DOSHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-605-9500
Mailing Address - Street 1:PO BOX 959061
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60195-9061
Mailing Address - Country:US
Mailing Address - Phone:224-238-4160
Mailing Address - Fax:847-214-9489
Practice Address - Street 1:804 WOODFIELD RD
Practice Address - Street 2:SUITE 300
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173
Practice Address - Country:US
Practice Address - Phone:847-605-9500
Practice Address - Fax:847-605-8700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-03
Last Update Date:2010-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036086709207RC0000X, 207RI0011X, 207UN0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
No207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional CardiologyGroup - Multi-Specialty
No207UN0901XAllopathic & Osteopathic PhysiciansNuclear MedicineNuclear CardiologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILIL1600Medicare PIN
ILIL1648Medicare PIN